Carpal Tunnel Syndrome: Don’t Wait!

10 Sep

Carpal tunnel syndrome (CTS) occurs when the median nerve is compressed as it passes through the wrist. Researches estimate that the average person has a one-in-ten chance of developing the condition in their lifetime, and the risk is higher for individuals in certain professions (such as those using heavy, vibrating tools) and with medical conditions (like diabetes). The symptoms associated with CTS involve pain, numbness, tingling, and weakness in the hands and fingers, typically sparing the pinky and outer half of the fourth digit.

Given that some of us are more likely than others to develop CTS, what should we do if we start to encounter symptoms associated with the condition? Is it important to seek treatment right away or is it safe to wait?

Generally speaking, the faster a patient seeks care, the quicker they will respond to conservative treatment options like those offered in a chiropractic clinic. Delaying treatment may mean a longer recovery or even having to consider more invasive options, like a surgical procedure. But why is that?

Like many cells in the body, the nerves are provided nutrients by way of blood vessels. When even a small amount of pressure is applied to the median nerve, it can damage those blood vessels. Unless the vessels are given a chance to heal, the nerve can suffer. If the nerve damage is severe enough, even surgery may not be an option, and a patient may have to learn to live with their pain or find other ways to mask their symptoms.

One big problem with CTS is that patients rarely wake up with severe wrist pain that prompts them to seek treatment. Often, the condition is subtle with pain, numbness, and tingling that comes and goes. Individuals with CTS may find it more of an annoyance than anything and tend to put off treatment until the symptoms cause too much of an impact on their quality of life to ignore and they’re forced to call the doctor.

The good news is that patients often respond well to conservative care. Chiropractors often diagnose CTS and can effectively manage it without the need for more invasive surgical intervention, but the prognosis for an effective treatment outcome declines with the greater the degree of nerve damage. Hence, patients are encouraged to seek treatment sooner rather than later when it comes to CTS. Care often includes manual therapies (manipulation/mobilization), education (rest, ice, brace, exercise), nutrition (anti-inflammatory in nature), and more.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Low Back Pain: Is It Your Feet?

6 Sep

The foot and ankle are unique in that their range of motion includes not only the front-to-back, hinge-like motion we associate with walking but also the lateral or side-to-side movement needed to change directions quickly. A problem in the foot can have a “domino effect’ that alters the biomechanics or the ankles, knees, hips, pelvis, low back, and even the neck—potentially increasing the risk of injury in each these areas.

Back in 1995, Rothbart and colleagues reported that hyperpronation—or excessive rolling inwards of the foot and ankle—is a leading cause of pelvic repositioning and mechanical LBP. Just watch people from behind as they walk in a mall, airport, or grocery store and you’ll notice almost everyone’s ankle rolls inwards as they step downward. To maintain proper foot posture, the use of foot orthotics is the most practical approach— coupled with wearing well-fitted, comfortable shoes, of course.

In a 2017 study, researchers recruited 225 adults with chronic LBP (more than three months) and randomly assigned them into one of three treatment groups: shoe orthotic (SO)-only, a “plus” group (SO + chiropractic manipulation/CM), or a waitlist group. The research team measured each participant’s pain and function/disability initially, after six weeks (the length of the treatment period), and then three, six, and twelve months later.

After six weeks, only members in the intervention groups reported any improvement in function. When comparing the waitlist and SO-only groups, the SO-only group demonstrated significantly greater improvements in both pain and function. The researchers also noted that members of the SO+CM group experienced even greater levels of clinically significant functional improvement.

This large-scale study supports the importance of examining the whole patient to identify and treat all factors that may contribute to a patient’s chief complaint.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

ADHD and Chiropractic Care?

27 Aug

Attention-deficit/hyperactivity disorder (ADHD) is a controversial diagnosis, as there are no clear objective clinical tests that can establish whether or not a patient has the condition. ADHD belongs to a spectrum of neurological disorders with no physiological basis (no clear lab tests exist) and often include other conditions such as learning disabilities, obsessive-compulsive disorder (OCD), or Tourette’s syndrome. Early-onset mania or bipolar mixed state can be difficult to differentiate from ADHD or they may co-exist with ADHD.

To complicate matters with regard to diagnosing ADHD, some kids may simply be at the high-end of the normal range of activity or have difficult temperaments. Poor attention may be caused by altered vision or hearing, seizures, head trauma, acute or chronic illness, poor nutrition, insufficient sleep, anxiety disorders, depression, and/or the result of abuse or neglect. Various drugs (such as phenobarbital) may interfere with attention as well.

Since the 1990s, the number of prescriptions to treat ADHD has skyrocketed 700%, possibly due to the increased awareness of the symptoms associated with ADHD and/or an increase in the diagnoses for ADHD, often demanded by frustrated teachers and/or parents. The classic medical model has embraced the use of Ritalin (methylphenidate) to treat ADHD. For parents who would like to explore other avenues of treatment, what can Chiropractic offer?

In a recent study involving 28 children aged 5-15 years with a primary diagnosis of ADHD, investigators randomly assigned 14 participants to a spinal manipulation (SM) group with conventional care and the other 14 to a control group (conventional care only). The researchers found the patients in the SM group experienced better outcomes based on several assessments and that a larger scale study would be necessary to verify their findings.

Nutrition may also have a role to play in the management of ADHD. In a 2015 study, researchers provided Lactobacillus rhamnosus GG (a probiotic) to infants at six months of age and then followed them for the next 13 years.  At age 13, six of the children in a placebo group had been diagnosed with either ADHD or Asperger syndrome while none of the kids in the probiotic group had been affected by either condition. The researchers concluded that probiotic use early in life may reduce the risk of neuropsychiatric disorder development later in childhood. We’ll cover this more in a future article…

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

What Leads to Chronic Whiplash?

20 Aug

Whiplash associated disorder (WAD) is a very common injury that can occur in a variety of ways, but it’s most commonly associated with motor vehicle collisions. The symptoms associated with WAD have been classified as follows:

  • WAD I: Pain, stiffness, or tenderness of the neck as the only complaint with no physical exam findings (full range of motion and no muscle guarding or tenderness on examination).
  • WAD II: Pain, stiffness, or tenderness of the neck with soft tissue injury signs loss of range of motion (ROM) and/or point tenderness of the neck (e.g., a sprain/strain neck injury).
  • WAD III: Pain, stiffness, or tenderness of the neck along with neurological signs sensory deficits, motor weakness, and/or decreased or absent deep tendon reflexes.
  • WAD IV: Pain, stiffness, or tenderness of the neck along with dislocation or fracture with or without spinal cord injury.
  • Other symptoms including deafness, dizziness, tinnitus (ringing in the ears), headache, memory loss, dysphagia (difficulty swallowing), and jaw pain can be present in all grades (WAD I-IV).

About 50% of WAD patients continue to report neck pain one year after the injury occurred. These long-term symptoms and signs can vary from mild to completely disabling.

There are prognostic factors that may help predict who is at risk of developing long-term, chronic (lasting longer than three months) WAD, which include the following (partial list): women more than men, age over 50 years, lower educational attainment, those who had pre-injury neck pain and/or headaches, the higher the WAD grade (comparing WAD I-III), those reporting more frequent or severe post-injury symptoms with greater pain intensity, poor coping at six weeks post-injury, depression, feeling helpless regarding pain control, fear of movement or activity, catastrophizing, anxiety, and high frequency pre-injury healthcare utilization.

There is evidence that WAD-injured individuals can develop widespread body pain or fibromyalgia in the year following their injury. This occurs more frequently in women and in those with poor prior health, greater initial symptoms (including pain intensity), and more symptoms of depression.

Among available treatment options, manual therapies such as mobilization and manipulation—the primary form of treatment delivered by doctors of chiropractic—often receive the highest ratings from patients in regards to overall satisfaction with care.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

When and When Not to Worry About Headaches…

16 Aug

Most people will experience some form of headache during their lifetime. The good news is that most headaches are related, at least in part, to the neck or cervical spine (a cervicogenic headache or CGH) and can be easily managed with chiropractic care.

Although the exact mechanism of CGH is still under debate, there are two possible explanations that are backed by research.  The first includes irritation of the sensory nerves in the upper cervical region that communicate with the fifth cranial nerve (the trigeminal nerve) and its nucleus, which is located in the upper cervical region of the spine. This irritation results in referred pain that radiates into the frontal aspect of the head. The second possible mechanism involves irritation of the greater occipital nerve by connective tissue bridges between the spinal cord covering (the dura) and the muscles located at the base of the skull.

Chiropractic treatment regarding CGH includes a combination of spinal manipulation; soft tissue therapies, such as myofascial release; active release techniques of the tight suboccipital muscles; manual and/or home cervical traction; and posture correction.

Unfortunately, the origin or cause of the headache may not be so benign and uncomplicated.  Warning signs of a complicated type of headache include (but are not limited to) the following: a very intense, unusual headache that comes on suddenly; significant visual and/or auditory problems; and other neurological signs and symptoms such as balance disturbance, dizziness, weakness, paralysis, speech difficulties, mental confusion, and nausea or vomiting. Until proven otherwise, the following types of headaches should be considered as potentially dangerous: a headache that progressively worsens over 24 hours; a headache that follows head trauma; and headaches that wake one up from sleeping, and/or last greater than 48 hours.

Doctors of chiropractic care are trained to evaluate and treat patients with headaches, and guidelines recommend chiropractic as an initial form of care based on its efficacy and safety.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

What Causes Shoulder Pain?

13 Aug

Each year, Americans make 7.5 million doctor visits related to shoulder/upper arm pain. After neck and back pain, shoulder pain is one of the top reasons patients seek chiropractic care. So, why are shoulder injuries so prevalent?

Though there are many possible explanations that address this question, there’s a simple answer: anatomy. There are essentially three joints that make up the shoulder: 1) scapulothoracic joint, 2) the glenohumeral joint, and 3) the acromioclavicular joint. These joints work simultaneously and in harmony to carry out the many tasks we throw at our upper extremities from swimming to swinging a tennis racket or even reaching up to hang a curtain or change a light bulb. The overall structure of the shoulder favors mobility over stability and as a result, there is a greater chance for injury. So, what can we do to prevent shoulder injuries?

Perhaps the most important strategy is to think before you act; that is, don’t take unnecessary chances such as over-lifting in especially awkward positions. Try asking someone else for help instead. Also, use proper form and stay conditioned. Research shows that a strong core (back and belly) can help prevent shoulder injuries.

Common shoulder conditions include (but are not limited to): inflammation (bursitis and tendinitis), instability (“sloppy” joints), arthritis (bone/cartilage injury/wear), fracture, and nerve injuries. Injuries can be acute (from an obvious cause) or more commonly, they can be chronic from wear and tear and can occur gradually over time (from no obvious, single cause).

It’s important to understand that a shoulder complaint may be the end result of dysfunction throughout the body, just as a knee problem can place added stress on the hip (or vice versa). So in addition to direct treatment of the shoulder, your doctor of chiropractic may identify and treat problems elsewhere in the body (forward head carriage, poor core strength, leg length deficiency, etc.) that likely contribute to your shoulder pain complaint. In order to promote a speedy recovery, your chiropractor may also recommend certain food or vitamins/supplements with the aim of reducing inflammation.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.
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